MARY K DERLACKI (NPI# 1609947431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609947431 |
| Entity Type | Individual |
| Full Name | MARY K DERLACKI |
| Credential | FNP |
| Practice Address |
132 E Broadway Suite 830 Eugene OR 97401-3160 |
| Practice Telephone | 5416870816 |
| Practice Fax Number | 5416871086 |
| Mailing Telephone | 5416870816 |
| Mailing Fax Number | 5416871086 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2010-07-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
090006104N1 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 005785 | 05 |
| Street Address |
132 E BROADWAY SUITE 830 |
| City | EUGENE |
| State | OR |
| Zip Code | 97401-3160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639178957 | Edward Mead Thatcher | Dentist | 132 E Broadway, Suite 629, Eugene, OR 97401-3143 | 2005-07-19 |
| 1427606219 | Anna Reichard | Psychologist | 132 E Broadway, Eugene, OR 97401-3143 | 2019-08-27 |
| 1750781225 | Shirree Eberhart | Physician Assistant | 132 E Broadway, Eugene, OR 97401-3143 | 2014-09-02 |
| 1013322411 | Steve Pethick, Phd | Community/Behavioral Health | 132 E Broadway, Suite 733, Eugene, OR 97401-3143 | 2014-06-24 |
| 1508282393 | Stuart E. Silberman, Psy.d., LLC | Clinic/Center | 132 E Broadway, Suite 730, Eugene, OR 97401-3143 | 2014-03-17 |
| 1467882068 | Matthew Dillender | Massage Therapist | 132 E Broadway, Suite 832, Eugene, OR 97401-3143 | 2013-11-18 |
| 1174871552 | Oregon Tlc | Physical Medicine & Rehabilitation | 132 E Broadway, Suite 716, Eugene, OR 97401-3143 | 2012-08-16 |
| 1255690699 | Edward M. Thatcher | Dentist | 132 E Broadway, Ste. 629, Eugene, OR 97401-3143 | 2012-05-04 |
| 1629384763 | Maria Aguirre | Psychologist | 132 E Broadway, Suite 500, Eugene, OR 97401-3143 | 2010-08-26 |
| 1215262779 | Margaret Vinolus | Social Worker | 132 E Broadway, Suite 825, Eugene, OR 97401-3143 | 2009-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427681709 | Sarah Voigt | Counselor | 2149 Centennial Plaza Suite #4, Eugene, OR 97401 | 2020-02-14 |
| 1801426242 | Therapeutic Associates, Inc. | Physical Therapist | 760 Charnelton St., Suite 760, Eugene, OR 97401 | 2020-01-24 |
| 1225676232 | Aaron James Barber | Massage Therapist | 1375 Pearl St, Eugene, Or 97401, Eugene, OR 97401 | 2019-12-20 |
| 1851957047 | Altru Home Care LLC | Nursing Care | 1345 Olive St., Eugene, OR 97401 | 2019-05-14 |
| 1881155208 | Herron Jordanna Spence | Speech-Language Pathologist | 385 West 2nd Ave., Eugene, OR 97401 | 2019-03-28 |
| 1750855094 | Brandon Marshall | Counselor | 1158 High St Ste 202, Eugene, OR 97401 | 2019-01-21 |
| 1881172591 | Kayla Nicole O'brien | Nurse Practitioner | Country Club In Eugene, 520 Country Club Road, Eugene, OR 97401 | 2018-08-03 |
| 1962992180 | Shannon Jensen Smyth | Counselor | Va Eugene Downtown Clinic, 211 E. 7th Ave, Eugene, OR 97401 | 2018-05-14 |
| 1902305956 | Christine Noel Gray | Peer Specialist | 499 W. 4th Ave, Eugene, OR 97401 | 2018-02-06 |
| 1821507344 | Anjuli Chitkara | Psychologist | 1679 Willamette Street, Eugene, OR 97401 | 2017-09-27 |
| Find all providers in zip 97401 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316035728 | Drs Cassell & Boren PC | Internal Medicine | 132 E Broadway Suite 830, Drs Cassell & Boren PC, Eugene, OR 97401-3160 | 2006-10-11 |
| 1093724247 | Sarah Cassell | Internal Medicine | 132 E Broadway Ste 830, Eugene, OR 97401-3181 | 2006-08-05 |
| 1790735561 | William Paul Maier | Internal Medicine | 633 E 11th Ave, Eugene, OR 97401-3602 | 2006-05-11 |
| 1245222322 | Cody Keith Wasner | Internal Medicine | 1200 Executive Pkwy, Ste 300, Eugene, OR 97401-2192 | 2005-08-16 |
| 1962690768 | N. Paul Hudson Md, PC | Internal Medicine | 2479 Oakmont Way, Eugene, OR 97401-6460 | 2007-10-06 |
| 1710107016 | William P Maier Md PC | Internal Medicine | 633 E 11th Ave, Eugene, OR 97401-3602 | 2007-04-27 |
| 1972677045 | Simona S Braun | Internal Medicine | 132 E Broadway, Suite 830, Eugene, OR 97401-3160 | 2006-11-20 |
| 1376614107 | Sidney L I Cassell | Internal Medicine | 132 E Broadway, Suite 830, Eugene, OR 97401-3160 | 2006-11-13 |
| 1053427666 | Norman Paul Hudson | Internal Medicine | 2479 Oakmont Way, Eugene, OR 97401-6460 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528295557 | Ajay Wanchu | Internal Medicine | 10101 Se Main St Ste 2011, Portland, OR 97216-2457 | 2009-06-17 |
| 1023229812 | Sarah Jan Lipton | Internal Medicine | 5050 Ne Hoyt St Ste 155, Portland, OR 97213-2956 | 2007-05-24 |
| 1871706218 | Shawn Gonda Macalester | Internal Medicine | 545 Se Oak St Ste F, Hillsboro, OR 97123-4147 | 2007-05-08 |
| 1053442855 | Arthritis and Osteoporsis Clinic LLC | Internal Medicine | 2200 Ne Neff Rd Ste 302, Bend, OR 97701-4279 | 2007-03-07 |
| 1215035449 | Mollie E Thompson | Internal Medicine | 9155 Sw Barnes Rd Ste 314, Portland, OR 97225-6630 | 2006-09-20 |
| 1417068198 | Ann Marie Macasa | Internal Medicine | 402 Villa Rd, Newberg, OR 97132-1831 | 2006-08-31 |
| 1912019217 | Michelle Marie Ryan | Internal Medicine | 3620 Nw Samaritan Dr Ste 202, Corvallis, OR 97330-3785 | 2006-08-31 |
| 1639114358 | Raymond Charles Hausch | Internal Medicine | 960 Liberty St Se Ste 200, Salem, OR 97302-4195 | 2006-06-17 |
| 1245283605 | Heather L Hansen-dispenza | Internal Medicine | 2965 Ne Conners Ave Ste 127, St. Charles Rheumatology, Bend, OR 97701-7753 | 2006-05-18 |
| 1003868720 | Jonathan David Jones | Internal Medicine | 3620 Nw Samaritan Dr Ste 203, Corvallis, OR 97330-4714 | 2006-05-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.